Provider Demographics
NPI:1083351316
Name:MICHEL, KATHERINE (DDS)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:MICHEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2850 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-7656
Mailing Address - Country:US
Mailing Address - Phone:850-484-4844
Mailing Address - Fax:
Practice Address - Street 1:2850 MONROE ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-7656
Practice Address - Country:US
Practice Address - Phone:850-484-4844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN268181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice